41NHA-S4031-Reference-Questionnaire.docx
DOCX document 41 KB Posted
- Attached to
- Rural Value Acceleration Network (RVAN) Vendor
- Solicitation number
- 41NHA-S4031
- Issued by
- Nevada
About this file
This is a reference questionnaire document issued by the Nevada State Purchasing Division, Department of Administration, in support of the Rural Value Acceleration Network (RVAN) Vendor formal RFP (Solicitation Number 41NHA-S4031) on behalf of the Nevada Health Authority. The questionnaire is designed to collect feedback from current and former clients regarding vendor performance on projects of similar size and scope. Completed reference questionnaires must be submitted to Heather Moon at hmoon@admin.nv.gov with the solicitation number in the subject line no later than November 25, 2026.
The reference questionnaire requires clients to rate vendor performance across thirteen evaluation categories using a scale of 0-10, where 0-3 represents below average performance, 4-6 represents average performance, 7-9 represents above average performance, and 10 represents exceptional performance. Rating categories include vendor knowledge and expertise, flexibility relative to scope and timeline changes, satisfaction with delivered materials and products, staff dynamics, schedule and deliverable timeliness, customer service responsiveness, billing accuracy, problem resolution capabilities, business requirement flexibility, and likelihood of future recommendations. The questionnaire also requests narrative responses regarding the capacity in which the client worked with the vendor, aspects of services most satisfying, and willingness to recommend the vendor again. Responses designated as unknown should be marked "U/K" and non-applicable items marked "N/A." Completed questionnaires are treated as confidential business information under Nevada Revised Statutes and are not subject to public disclosure; the State reserves the right to contact references for additional clarification.
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| 41NHA-S4031 - Insurance Schedule - RFP.docx | DOCX document | |
| 41NHA-S4031 - Cost Schedule.xlsx | XLSX spreadsheet | |
| 41NHA-S4031 - Business Associate Addendum.docx | DOCX document | |
| 41NHA-S4031-Vendor-Information-Response.pdf | ||
| Terms-and-conditions-for-services~9.pdf | ||
| 41NHA-S4031-Request-for-Proposals.docx | DOCX document | |
| 41NHA-S4031 - Business Continuity Agreement.docx | DOCX document | |
| Standard-form-contract~8.docx | DOCX document |
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Text version
Nevada State Purchasing Division Department of Administration 515 E Musser St Ste 300 Carson City, NV 89701 purchasing.nv.gov nevadaepro.com
Reference questionnaire
Due Date 11/25/2026
Solicitation number 41NHA-S4031
Single point of contact name Heather Moon
Single point of contact email hmoon@admin.nv.gov
Proposing vendor or subcontractor
Client providing the reference
Client contact name and title
Client telephone and email
Period of performance
1. Client reference instructions
1.1. As part of a formal solicitation the State of Nevada has requested vendors provide references from current and/or former clients for projects of similar size and scope. This reference questionnaire is to provide a client reference for the proposing vendor or subcontractor above. Once you have completed the reference questionnaire, please submit to the single point of contact via email, with the solicitation number in the subject line, no later than the due date above.
1.2. The State requests all questions be answered. If an answer is not known, please answer as ‘U/K’. If the question is not applicable, please answer as ‘N/A’. If additional space is needed to answer a question or provide a comment, please attach additional pages. If attaching additional pages, please place your company/organization name on each page and reference the appropriate RFP number.
1.3. Do not return the completed reference questionnaire to the proposing vendor. To allow for candid responses, completed reference questionnaires are designated as confidential business information by the Administrator pursuant to NRS 333.020(5(b) and not public information pursuant to NRS 333.333. In addition to the reference questionnaire, the State may contact references for further clarification.
Where a rating is requested, please provide a rating between 1-10. For all items, please provide any comments you feel would be helpful to the State in evaluation below each item. Poor or inadequate performance: 0; Below average performance: 1-3; Average performance: 4-6; Above average performance: 7-9; Exceptional performance: 10.
Evaluation items
In what capacity have you worked with this vendor in the past? (no rating)
Vendor’s knowledge and expertise, rating:
Vendor’s flexibility relative to changes in scope and timelines, rating:
Your satisfaction with delivered materials, rating:
Dynamics and interaction between the vendor and your staff, rating:
Your satisfaction with products developed by the vendor, rating:
Was the schedule met and deliverables timely? Rating:
Overall customer service and timeliness in response and issue resolution, rating:
Accuracy and timeliness of billing, rating:
Vendor’s ability to quickly and thoroughly resolve a service-related problem, rating:
Vendor’s flexibility in meeting business requirements, rating:
Response time and customer service of local office, if applicable, rating:
Likelihood of recommending this vendor to others in the future, rating:
Which aspects of this vendor’s services are you most satisfied with? (no rating)
Would you recommend this vendor to your organization again? (no rating)
Revised 2024-10 Page 2 of 2
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